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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197420015
Report Date: 08/01/2024
Date Signed: 08/01/2024 01:24:34 PM

Document Has Been Signed on 08/01/2024 01:24 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MONTESSORI WOODLAND HILLSFACILITY NUMBER:
197420015
ADMINISTRATOR/
DIRECTOR:
ZOHRA BAREKZAIFACILITY TYPE:
850
ADDRESS:6104 FALLBROOK AVENUETELEPHONE:
(818) 340-4404
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY: 54TOTAL ENROLLED CHILDREN: 40CENSUS: 29DATE:
08/01/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Beatrice Ruiz, Adminstrator TIME VISIT/
INSPECTION COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced random annual inspection on 08/1/2024. LPA arrived at the facility at 10:30 AM. LPA met with Administrator Beatrice Ruiz who guided analyst on tour of the facility. This is a preschool program licensed for 54 preschoolers. Facility consists of 3 classrooms. Hours of operation are Monday through Friday from 8:00 AM to 5:00 PM.

All areas identified on the Facility Sketch were inspected. The following staff were present during this visit: Room #4: 2 Staff with 18 preschoolers, and room #3 with 2 staff and 11 preschoolers.

Teacher/child ratios were observed to be in accordance with Title 22 regulations. The Administrator is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. Linens are given to the parents each week to take home and wash. Napping equipment (mats) were observed in a separate storage room. Per Administrator, the isolation area is located in the office, or in the room adjacent from the office. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms.



General sanitation was observed. Drinking water is available use of a water cooler system observed in the classrooms. Pitchers or children’s water bottles are brought outside for outdoor drinking water. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Carbon monoxide detector were observed in the classroom and is operable.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MONTESSORI WOODLAND HILLS
FACILITY NUMBER: 197420015
VISIT DATE: 08/01/2024
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All food preparation and storage areas are clean, free of litter/rubbish and free of rodents/vermin. Facility was not observed with a full-service kitchen. Facility provides snacks and children bring their own food from home. All food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available use of a water cooler system observed in the classrooms.

Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

Children’s records were reviewed for Admission Agreement, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 613-Personal Rights, LIC 702-Health History, and LIC 701 Physicians Report, and Immunization Records.

Staff records were reviewed for Education, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, LIC503- Health Screening, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.



Administrator was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personal, and administrative records. For IMS information see


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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MONTESSORI WOODLAND HILLS
FACILITY NUMBER: 197420015
VISIT DATE: 08/01/2024
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Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417.

The following information regarding ADA was provided: US Department of Justice (USDOJ) toll free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Center and the ADA, available at: http://www.ada.gov/childqanda.htm

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today. Exit interview conducted and report was reviewed with Administrator, Beatrice Ruiz. A notice of site visit was given and must remain posted for 30 days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/tion-process.

SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
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